The use of steroids has long been reported many side effects. Steroid-induced mental disorder is one of many complications associated with corticosteroid therapy. Steroid psychosis is not common disease but it may be more popular due to high steroid therapy such as pulse therapy or high dose steroid therapy. Euphoria, irritability, insomnia, and hallucination are predominating symptoms. The dosage, duration of the treatment may not be correlated with the time of the onset, duration, severity, or type of mental disturbances, but the risk of developing psychosis is increased to the high dose of steroid. It is usually reversible on dose reduction or discontinuation of the drug.
Euphoria ; Hallucinations ; Mental Disorders ; Psychotic Disorders* ; Sleep Initiation and Maintenance Disorders ; Steroids

Ror fetal sex determination by the PCR method, oilgoprimers to Y- chromosome gene, DYZI, SRY, and AMGL were synthesized genomic DNA was extracted from male and female placenta for the control use. DYZI represented 154 bp single band to 0.001 pg/ml male genomic DNA but did not represent 154 bp band in female genomic DNA, SRY represented 341 bp bandto 1 pg/ml male genomic DNA in 2% agarose gel eleftrophoresis stained with ethidium bromide. DYZI was 1,000 fold sensitive than Sry and AMGL. DYZI and SRY could not identify the PDR failure from female but AMGL identified to 1,000-fold. During the dyal ampiification of female genomic DNA mixed with male genomic DNA, 0.00125 pg/nl, 1:400 part, male genomic DNA contamination represented male band but SRY amplification did not represent male band. It was suggested that SRY gene was deleted in two 46,XY felmle cases. For fetal sex determination, PCR with DYZL, SRY, and AMGL was performed in 10 cases. For fetal sex determination, PCR with DYZL, SRY, and AMGL with karyotyping in 10 cases of chorionic villi sex dietermination, PCR with DYZI, SRY, and AMGL was performed in 10 cases. For feral sex determination, PCR with DYZI, SRY, and AMGL with karyothping result, fetal sex determination, PCR with DYZI, SRY, and AMGL was performed in 10 Cases of choricinic villi and 15 cases of amnionic cells. By the comparison with karyotyping result, fetal sex determination was achieved successfully in all 23 samlies using PCR of SRY and AMGL but false result was detected in 3 cases(13%) using DYZI. Acording to our results, it was concluded that DYZL was 1,000-fold sensitive than SRY and AMGL but could not be used because of its false results, and AMGL and SRY must be used concomitantly for precise sex determination.
Amnion ; Chorionic Villi ; DNA ; DNA Contamination ; Ethidium ; Female ; Genes, sry ; Humans ; Karyotyping ; Male ; Placenta ; Polymerase Chain Reaction* ; Sepharose

Conjoined twinning is a rare congenital malformation, accounting for 1% monozygotic twins. Conjoined twins result if twining is initiated after the embryonic disc and rudimentary amniotic sac have been formed and if division of the embryonic disc is incomplete. Recently we experienced a case of conjoined twins, dicephalus dipus dibrachius, who had died at 3 hours of life, and performed autopsy. Autopsy revealed a total duplication of the heads, spines up to sacrum, small bowels, thymus and lungs. Two hearts existed within a common pericardium.
Autopsy ; Head ; Heart ; Humans ; Lung ; Pericardium ; Sacrum ; Spine ; Thymus Gland ; Twins, Conjoined* ; Twins, Monozygotic

A case of chronic epidural hematoma in the left frontal region is presented. The patient presented with a unique neurologic sign, exophthalmos, which was not a result of the injury but of in-growth of granulation tissue of the hematoma capsule into the orbit through the orbital roof defect. The time interval between head injury and the operation was about 25 years. Our case represent the second most longest time interval among the reviewed literatures.
Craniocerebral Trauma ; Exophthalmos* ; Granulation Tissue ; Hematoma* ; Humans ; Neurologic Manifestations ; Orbit

OBJECTIVES: This study was performed to consider the clinical experience of an ultrasound-guided vacuum-assisted resection (Mammotome) for benign breast lesions through a core needle biopsy. METHODS: The authors carried out a core needle biopsy and Mammotome for 347 patients and investigated the pathologic results. RESULTS: The significant difference of core needle biopsy and Mammotome results was demonstrated, Spearman correlation coefficient is 0.413 in a correlation analysis. CONCLUSION: This experience suggest Mammotome is a useful procedure for providing more correct pathologic findings through complete resection of benign breast lesions.
Biopsy, Large-Core Needle ; Breast ; Breast Diseases ; Breast Neoplasms ; Humans ; Mammography ; Needles

A rare case of Takasu's arteritis associated with subarachnoid hemorrhage and intracranial aneurysm is described. It is well known that diseases such as intracranial venous malformations, carotid artery stenosis, moyamoya syndrome, brain neoplasm, coarcatation of aorta, polycystic kidney disease, connective tissue diseases, etc are often associated with aneurysms, however an association with Takayasu's arteritis has not been reported. We discussed clinical features, radiologic finding, treatments of the case and reviewed the literatures of this disease entity.
Aneurysm ; Aorta ; Arteritis ; Brain Neoplasms ; Carotid Stenosis ; Connective Tissue Diseases ; Intracranial Aneurysm* ; Moyamoya Disease ; Polycystic Kidney Diseases ; Subarachnoid Hemorrhage* ; Takayasu Arteritis*

The growth or rebleeding of the spontaneous ICH is catastrophic so that prevention of them is critical in management. We reviewed 233 cases of spontaneous ICH from Jan. 1990 to Dec. 1994 to evaluate the factors associated with the hematoma enlargement. The relationship among the admission time from hematoma onset, the systolic BP at admission, hemostatic parameter, liver dysfunction with rebleeding incidence were assessed. Also, hematoma shape, density, site, volume, and operation tiem from hematoma onset were evaluated. Hematoma growth was oserved at 26 patients(11.6%). Incidence of rebleeding was significantly associated in patients with shorter admission time from hematoma onset, high systoic BP at admission, inhomogenous, irregular-shaped hematoma at CT and liver dysfunction. The incidence of hematoma growth was higher in the early operation group but there was no significant relationship in statistic analysis. Patients admitted within 6 hours of hematoma onset, with irregular-shaped, inhomogenous hematoma on CT, and liver dysfunction should be observed closely for the enlargement of hematoma. The operation time might be delayed at least 6 hours after hematoma onset.
Cerebral Hemorrhage* ; Hematoma ; Humans ; Incidence ; Liver Diseases

PURPOSE: To compare the findings of early periventricular leukomalacia on MR imaging and on US. MATERIALS AND METHODS: MR imaging was performed in 17 neonates in whom well-demarcated increased periventricular echogenicity was seen on sonography. One more patient was included during the same period because MR imaging of this patient showed a periventricular lesion not suspected on previous US. Initial sonography was performed within 6 days of birth and was followed up between one week and one month later. MR images were obtained within the first month of life. RESULTS: Twelve of 17 neonates showed abnormal periventricular signal intensities on MR imaging. Follow up sonography revealed cystic changes in two cases and heterogeneous hyperechogenicities in three. All patients except the two with cystic changes showed normal periventricular echogenicity on final sonography, On MR imaging,11 cases showed multifocal periventricular increased signals on T1-weighted images, and two cases showed mainly decreased signals representing cysts. Positive findings were more evident on T1-weighted than on T2-weighted image. CONCLUSION: on T1-weighted imaging, the characteristic finding of early periventricular leukomalacia was multifocal periventricular hyper or hypointensities, and hyperintense lesions were more common than hypointense. In the diagnosis of early noncystic periventricular leukomalacia, MR imaging was more objective than US.
Diagnosis ; Follow-Up Studies ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Parturition

BACKGROUND: Epidural infusions usually comprise a local anesthetic, an opioid, or more commonly, a combination of the two, to minimize individual doses and to reduce unwanted side effects. The aim of this study was to compare analgesic and side effects of epidural infusion with 0.2% ropivacaine alone and in combination with 4 microgram/ml fentanyl after total abdominal hysterectomy. METHODS: Forty healthy total abdominal hysterectomy patients under general anesthesia with postoperative analgesia by continuous epidural infusion were randomly allocated into Group I; 0.2% ropivacaine alone (n = 20) or Group II; 0.2% ropivacaine and 4 microgram/ml fentanyl (n = 20). We assessed the visual analogue scale (VAS, 0 = no pain, 10 = worst pain), frequency of supplemental analgesics, side effects and patients' satisfaction of the result. RESULTS: The VAS and the frequency of supplemental analgesics were significantly lower and fewer in Group II compared to Group I. The incidence and severity of side effects were no differences between two groups. The satisfactions of patients were significantly higher in Group II. CONCLUSIONS: For postoperative analgesia, the epidural infusion of 0.2% ropivacaine with 4 microgram/ml fentanyl provided better analgesia than 0.2% ropivacaine alone.
Analgesia* ; Analgesics ; Anesthesia, General ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence

We describe here a case of difficult intubation due to pseudoankylosis of the temporo-mandibular joint after a pterional craniotomy. A 50-year-old female was admitted to our hospital presenting with severe headache. According to her angiogram, a ruptured aneurysm in left posterior communicating artery (PCoA) and an unruptured right PCoA aneurysm were detected. We the operation in two-steps; the first operation for the left PCoA proceeded without any problem, and the tracheal intubation also was not difficult. Four weeks later, while inducing the general anesthesia for her second operation, severe trismus was detected after the infusion of propofol 120 mg. While ventilating the patient with a well-fitted mask, we performed several attempts of conventional tracheal intubation, and the patient was finally managed using a ProSealTM laryngeal mask airway with controlled ventilation. According to patient's history, trismus has also occurred after her first operation. We think that the reason for her trismus was a result of contracture of the temporalis muscle after her first pterional craniotomy.
Anesthesia, General ; Aneurysm ; Aneurysm, Ruptured ; Arteries ; Contracture ; Craniotomy* ; Female ; Headache ; Humans ; Intubation* ; Joints* ; Laryngeal Masks ; Masks ; Middle Aged ; Propofol ; Trismus ; Ventilation